5 Resources for Supporting Individuals with CVI Who Are Learning to Use AAC

I was inspired yesterday by a low vision specialist who came to an AAC workshop I did in north central Florida. Time for a little resource sharing!

1. Texas School for the  Blind and Visually Impaired Outreach Program: This site has a wonderful introduction to the various aspects of cortical visual impairment with many short videos on intervention to help maximize visual skills.

2. Introducing Your Blind Child to a New Teacher: Helpful information and downloads from Perkins and the Wonder Baby project.


3. Team Approach to CVI In Schools: Booklet by Little Bear Sees


4. Thinking Outside the LightBox: This is an active Facebook group with helpful information, resources, and timely announcements.


5. Sneak Outside the Box: Wonderful blog by SLP Tanna Patterson Neufeld with good ideas for therapy, play, and education many of which are applicable to children with CVI.

HijAACked! AAC and Anti-Bullying with Stand Tall, Mary Lou Melon!

Stand Tall, Mary Lou Melon by Patty Lovell is a fun book that we like reading online* with kids who use AAC. Many schools have anti-bullying campaigns and read this book and others as part of their efforts to help children recognize and respond appropriately to unkind words and deeds. There are a lot of great resources for reading this book on sites like this one intended for use in general education classrooms. We decided it was time to HijAACk Mary Lou and share some ideas for using this wonderful story to build AAC and language skills.

1. Beginning communicators could certainly contribute to the ‘read aloud’ portion of the activity with repeated lines, like “So she did.” Recording that into a single message device, an SGD, or an AAC app gives our student a terrific way to be actively engaged.


2. Students who can discriminate between two options can get involved at another level. There are many pages in the story where something is said that is either nice or nasty. We could give our beginning AAC users comments appropriate for each of them. On the relevant pages they could then chime in with an appropriate positive or negative comment, such as “That’s great idea!” or “Hey, that’s not nice!”


3. Many classrooms use downloadable worksheets like this one, meaning that our AAC kids need accessible materials. In a perfect world, the worksheet would be available in the appropriate accessible format but that’s not the world that most of us live in. Activities like this provide a good opportunity to teach our kids to take control and give directions when those materials aren’t in place. While we’re huge fans of the core language approach, prestored messages can really come in handy here. “Where’s the scanned version?” “Can you please scan it for me?” “It’s in my IEP.” “Thanks for your help.” “Next time, can you please do it in advance?” It’s never too soon to teach age appropriate self advocacy skills.


4. Use a “Find and Replace” activity to help build vocabulary and/or give core word practice. When we come across expressions like ‘fumble fingered,’ we can put those into our own words using core language (e.g., hands not move good; hard time doing it; clumsy). Highlight those expressions in the book with removable highlighting tape so that when we come across the terms, students know to replace it with words of their own choosing.


5. Because this book is used in classroom discussions about bullying, we have the chance to think about and practice how to respond to mean comments. Some well-chosen retorts (appropriate for the age and situation) can be selected with the student, family, and teacher, and programmed into the SGD. This will give the student an appropriate way to participate in some of the discussions and role play activities that are going on in many classrooms that focus on character building.  


6. Non-literal language: This is a great book to use to talk about idioms and metaphors. What does it mean to ‘stand tall’? Do you really have to be able to stand up to do that? What other ways could we say this? “Be proud, Mary Lou Melon.” “Stay strong.” Cement the learning experience by re-reading the story with the AAC user’s alternate wording...

7. Personal narratives: Tell about a time when you saw or heard people being mean. Give an example about when someone gave you advice or suggestions.

Hope you have a chance to use and/or share these ideas for this HijAACked book.

Magic Moments: Ideas for AAC Intervention with BrainPOP

There’s so much to love about BrainPOP. Geared for students in 4th-12th grades. Solid curricular content. Engaging animation and really fun educational games. Aligned with Common Core. Searchable by learning standard, subject, or grade level. Built-in assessment. Evidence-based. Web-based and app versions. Closed captioned videos. English and Spanish editions. Additional resources for educators. A simplified version for younger learners. And lots of it for free!

We’ve just scratched the surface of this wonderful site, which has been around since 1999, and is growing in depth and breadth. It’s perfect for some of the older students with whom we work and has a lot of potential for AAC learning.

1. Navigation: Even some of our older students are still learning to find their way around complex AAC systems. The engaging content in the BrainPop videos create a fun context for activities to practice navigating around an AAC device. We’ve had a great time randomly stopping the video, selecting a word, thinking about where it might be stored, and how to use the SGD to say it.

2. Circumlocution: As SLPs, most of us spent plenty of time helping adults with aphasia and others with word-finding problems overcome their tendency to use circumlocution. In the mother of all ironies, we now teach that as a valuable skill to kids with a rich core language base. Don’t have the word ‘parallel‘ and can’t quite spell it? That’s okay. ‘Two lines not come together’ will do quite nicely. Kids love to pick words out from the BrainPop videos and then race to see who can come up with the best way to tell about that word.


3. Main Idea: So many of the AAC students with whom I’ve worked have had persistent problems with relevance. Picking out the main idea in a textual passage is so important to their academic achievement and yet such a difficult thing for many of them to do. The BrainPOP Main Idea video explains the concept perfectly and gives great examples. There are enough practice activities so that it really sinks in. Because they are learning via video, rather than reading, we can really focus on the concept of main idea without the additional challenge of text processing.


4. Semantics: This is such a great tool for helping students learn new words. Because it is curriculum-driven, we have the opportunity to pre-teach some of the vocabulary that these kids will need to know for class discussions, reading their textbooks, completing writing assignments, and taking exams. When we encounter new words in BrainPop videos, we can pause to put some of our strategies for new word learning into action.    

5. Lexical Diversity: We’ve all worked with students who tend to use the same tired words over and over. Building lexical diversity is fun with BrainPop because the engaging video provides such a rich context. If you already have a list or graphic organizer with new ways to say those over-used words, review that before starting the BrainPop video. Stop the video when you hear the over-used word, and talk about which of your alternatives would work in that context.

Hope to hear from some of you with more ideas for making Magic Moments with BrainPOP.

Beyond Good and Nothing: Inquiring Moms & Dads Want to Know

“How was school?” (Good) “What did you do?” (Nothing)  

This scenario plays out in many cars and kitchens in the after school hours and it can be hard to know who is more frustrated: the kids for being asked or the parents for not getting satisfactory answers. And still, we repeat the process day after day. Of course, we want to know the fine details of what happened and how our children felt, but in some cases, we’d settle for ANY school-related conversation at all. 

I’ll be the first to admit that it took me way too long to get the hang of how to get information about my children’s school days, and it seemed like just when I did, pow! They were pre-teens and then teenagers. New rule book.

Here are some ‘lessons learned’ along the way about those afterschool conversations and some suggestions for parents of the kids on your caseloads who use AAC.

General Thoughts

1. Remember, they can only tell you what they can tell you. Be thoughtful about how you ask. If they don’t have the means to answer a certain question, they can’t possibly respond and you’ll both be frustrated.
2. Visual Schedule: If the child uses one for structuring daily activities, put an ‘afterschool conversation’ or ‘school talk’ activity into the routine for afternoon or evening. Setting an expectation for this kind of conversation and making it part of the routine helps to give the child a lot of practice.
3. We tend to like things that we’re good at. Sometimes, kids resist these conversations because they are difficult. Do what you can to make it easier.
4. Use visual supports. A visual representation of things to talk about or a copy of their daily schedule at school can help jog a tired child’s memory.
5. Model. Tell a little about your day. Give it the sound and feel of what you hope to get eventually from the child (e.g., chronological order; something novel; one good thing).
6. Rating scales work well for many children. You can see some that we use here (mouse over the bottom part to print, save, or download).

Beginning Communicators

1. Make sure that they have the appropriate vocabulary within their AAC systems.
2. Use aided language input as you speak.
3. Use visual supports, such as a replica of their school schedule or pictures of teachers and classmates, as you speak.
4. Try asking forced choice questions (e.g., “Did you have art or music today?” “Did you see Lissa or Robert?”). It helps if you know the right answers so that you can model the correct response if the child gets it wrong.
5. For very beginners, try questions of affirmation along with the appropriate visual support. E.g., show picture of teacher; “Ms.Humphrey. Did you see Ms. Humphrey?” show symbol for recess; “Recess. Did you have recess?”
6. If the child doesn’t respond after a 10 second pause, model the correct answer and help the child do it, too. “Yes. Mrs. Humphrey. You saw. Ms. Humphrey.” “Art. You had art today.”  
7. If the children use AAC systems that are rich in core language, this is a good time to practice. It’s a little tricky, but with practice you can get into the habit of framing the question so that they always have a means of responding using core words. Later this week, we’ll post a PDF of suggestions for core language conversations.
8. Try using a script that has predictability and structure. Plan a conversation that has 2 turns for each of you and develop a script with appropriate visual supports. For example:

Forced choice

Parent: “Who was your lunch buddy, ___ or ___ ?”

Child: “___” (with AAC)

Parent: “Was it fun or not fun?”

Child: “Fun” (with AAC)

Affirmation

Parent: “Story Circle. Did you have Story Circle today?”

Child: “Yes” (with AAC)

Parent: “Special letter. Did you see the special letter?”

Child: “Yes” (with AAC)

Kids with Fairly Robust Language Skills

1. Try comments rather than questions
1. About something they did or handed in: “I bet your teacher noticed the practice you did with your math facts.” “I was thinking about you and your spelling quiz today.”
2. About something you observed: “That looks like a lot of books to lug home.” “It looked like Maya had a birthday hat when she came out.” “You look pretty worn out.” “Mrs. Ward seemed to be rushed this morning.”
2. Preview the conversation. Give them some time to prepare mentally.
1. “Later on, I’d like to hear about....” “When you get a chance, fill me in on....” “After you change, let’s talk about...” “At snack, I want you to tell me 2 things about...”
3. Use a visual schedule. For kids that do well with structure, put an ‘Afterschool Conversation’ in the schedule for the afternoon or evening. Keep the conversation short and easy at first, then build from there.
4. Make a prediction. “I bet you were glad that ….” “Maybe you’ll have a sub tomorrow.” “I wonder if Mr. Marlow will do Recess Warriors this week.”
5. Be wrong. Say something plausible that you know is likely to be incorrect. For some kids, nothing is more motivating than the chance to correct an adult.
6. Ask specific questions. Here are some good suggestions from iMOM (and downloadable PDFs)

After school conversations are about sharing things that happened in a different place and time. It’s a bit abstract and can be challenging. We don’t give our kids a lot of practice talking in the past tense, and it may not be very meaningful to them at first. Repetition is the key. Manage your expectations because this takes some time. But eventually, you’ll get beyond “Good” and “Nothing.”

Singing in the Rain (Thanks, Isaac!)

By tradition, we post an AAC-related video on Sundays. Today, we’re thinking that it’s time for a song, and those who attended ISAAC 2012 know that there’s nothing like the songs sung using AAC. This video features an adaptation of a classic folk song, If I Had a Hammer, performed by the talented Snoopi Botten.

Lightning, Thunder, & Rain Oh My

We live in Florida and there are lots of general summer storms. They can be very loud and dark.  There are also many hurricane warnings (like now for Hurricane Isaac).  Many children and adults with communication challenges can become upset or anxious because of the loud noises, the change in routines, and/or the heightened state of anxiety that is usually around the house or community. Because of this we are often asked to help find visual support resources. Here are some great prepared visual support stories and resources that we use:

Bad Weather Tips and Story by Hands in Autism
Hurricane Preparedness
More Hurricane Preparedness
Thunder/Lightning Storms
Thunder Box

Sometimes though the prepared supports do not meet the needs for specific learners. Here are our tips for developing your own storm visual supports and resources

Creating Personal Participation Stories

• Use language of the story that is at the level of the learner

• Use picture symbol support for the text of the story
• Write about possible or known problems for the specific learner with the event, activity, or experience (i.e., the noise, the fact that you can not go outside to play, etc)
• Write about possible solutions for the specific learner with the event, activity, or experience (i.e., you can wear headphones and listen to music to not hear the storm, etc)
• Use non-specific language (i.e., ‘probably’, ‘will try’, ‘may’, ‘about’ -vs- ‘will’, ‘must’, ‘have to’)
• Conclude on a positive note

Creating Visual Support Resources

• Use choice boards for things you can do inside during a storm
• Use a monthly calendar to show when you probably can have a ‘make up’ for any event that got cancelled
• Relaxation ‘bag’ with relaxing objects (i.e., stress ball, massager, etc) and visual instructions for relaxing activities (i.e., yoga, deep breathing, etc.)
• Feelings board to ‘vent’ about any anxiety
• Storm ‘bag’/’box’ with special things that can be used inside during a storm and supplies for a storm (i.e., extra batteries, favorite books, music player, etc.)
• Any other visual support that gives the learner information or allows them to express their thoughts

5 Presentation Handouts from ISAAC 2012

It seems like only last week that I was enjoying ISAAC 2012, spending time with friends, and attending AAC sessions. Here are some links to handouts for a few of the sessions.

1. Sarah Blackstone and many others: Effective Patient Provider Communication: The Expanding Role of our Professions


2. Jane Farrall: What’s APPropriate: AAC Apps for iPhones, iPads and other devices


3. Melanie Fried-Oken: A Comparison of Communication Board Use for Conversations in  Primary Progressive Aphasia and Alzheimer’s Disease


4. Janice Light and her colleagues: Effects of AAC Systems with “Just in Time”  Programming For Children with Complex Communication Needs


5. Janice Light & David McNaughton: Evidence-based Literacy Intervention for Individuals with Autism who Require AAC

5 Things We Love About the AAC Evaluation Genie

We loved it as a computer program and now we love it as an app. 

1. The AAC Evaluation Genie app covers a lot of ground, starting with simple discrimination tasks all the way up through word prediction.

2. It helps keep us organized and focused in the app portion of the assessment process: The way the assessment activities are laid out helps us move beyond picture identification in a organized fashion.

3. It allows for a lot of flexibility. How many times have you done an AAC evaluation where you prepared for a client with a certain set of skills, only to find yourself face-to-face with someone whose skills are way above or below what you planned for? It’s great when you have a tool that will let you move easily to another set of tasks when the need arises.

4. It accommodates both direct selection and scanning. 

5. The testing process also helps us teach the client what to do. In the picture discrimination set, for example, we can start at a very easy level (e.g., set of three 5-inch pictures) to help the client gain experience with the task so that when we get to the larger fields (it goes up to 32 1-inch pictures), the client knows what to do. The Genie makes it progressively more challenging and allows us to see how the client does with an increasingly larger field of options.

Thanks, Celeste Helling, for this very useful tool!

Comparing AAC Apps: A Look at the Language & Other Features

Well, the school year is all of 3 days old and already we’ve had plenty of questions about AAC apps. Sigh. We’ve had our ups and downs with AAC on mobile devices, but there is no sense rehashing all of that here. Instead, we’ll focus on some of the tools we use when helping to determine which, if any, are a good fit for a particular communicator.

AAC App Lists:

• Comprehensive AAC app list for iPhone and iPad by Jane Farrall

Feature Match Checklists & Forms:

• Jessica Gosnell at Boston Children's Hospital
• Scott Marfilius and Kelly Fonner

Our Rubric for Evaluating the Language Aspects of the AAC App

• RELAACs

Other Helpful Sources

• Scoop.It collection and Pinterest boards with AAC app sites and videos
• OCALI’s listing of apps for individuals with ASD
• Tech Connect’s Apps Assistant
• The App Academy’s site for app training videos

While We’re Waiting & the ‘Aha Moment’

We tried to be patient. We really did. We tried to wait until we had the new venue for our site all figured out and ready to go, but the truth is, we missed blogging and hated the thought of going a few more weeks without being able to post. So we decided to reactivate our old site for the time being and post occasionally to this site. Pardon our dorky look, please.

In case you missed these on Facebook, here are are a couple of things we shared in the past few weeks:

• Lemonade: http://screencast.com/t/xaFcbxySW
• Building Classroom Participation: http://www.screencast.com/users/CZee/folders/Jing/media/15818f72-c49f-4da6-a12d-e52250794234
• PrAACtical Alert: Online Trainings: http://bit.ly/NZ9HYT

• COCOA: http://www.edutecher.net/educlipper/index.php?shareImgid=2478
• AAC Rating Scales: http://www.edutecher.net/educlipper/index.php?shareImgid=2499 and http://bit.ly/Ocgte5

And now onto something new...

Last week, I had the chance to talk with Karyn, a mom whose adorable daughter with significant vision impairment and multiple disabilities is entering school for the first time. As she helped her little girl prepare for the transition, Karyn had an ‘aha’ moment. Up until now, she dutifully implemented the suggestions of the SLP, OT, PT, and early intervention teachers who worked with her daughter, Ella, trying to strike a balance between their home programs and the other demands on her time. AAC was a part of that, along with many competing priorities, but it never really got air play. Because Ella primarily had in-home services, Karyn was always available to interpret her daughter’s communicative attempts. Now, Ella is going to be on her own, without mom to interpret.

In this case, the ‘aha moment’ was Karyn realizing that for her daughter to succeed in school, AAC would have to play a central role. The people who are now going to be with Ella for 6 hours/day, aren’t familiar with the ways in which she communicates using sounds, subtle movements, and changes in muscle tone. “I took pride in being the one who knew her best,” Karyn told me. “I guess a part of me was secretly happy that I could read her better than anybody else.” “We’re a team,” she said, “but now she’s playing in a whole new league.”

A whole new league, with all new rules.

Karyn’s ‘aha moment’ sent her into a tailspin, and she wakes up in the night worried, as any mom in this situation would, about helping her daughter be safe, happy, and productive in school.  We brainstormed well into the night, and one of the brightest moments was a plan to introduce object symbols. Tangible symbols are a great option for kids with significant visual impairment, and we chatted about how to get started to develop a system that would allow Ella to make choices and know what’s coming up in her day. Perkins School for the Blind has a wonderful set of videos  by SLP Elizabeth Torrey on this topic. There are 6 short, expertly captioned videos totalling less than 15 minutes. They give a great introduction to how to get started with this approach.

You can view the videos here: http://bit.ly/PCScxm